Avian influenza A (H5N1) infection in a child.

A previously healthy, 9-year-old girl was admitted to the hospital with respiratory insufficiency. She had mild and severe respiratory symptoms for 3 weeks and 4 days before admission, respectively. She had a history of close contact with her domestic poultry, which was infected with avian influenza A (H5N1). She was isolated with the air-borne transmission prevention mode of treatment. Acute respiratory distress syndrome (ARDS) was documented from the time of admission and mechanical ventilation was introduced without improvement. She had multiple episodes of diarrhea for 2 days. Her condition deteriorated and she expired in 4 days. Throat swab RT-PCR and viral culture for avian influenza A (H5N1) were positive.

DHF in infants, late infants and older children: a comparative study.

A comparative study of dengue hemorrhagic fever in infants and children was conducted at the Department of Pediatrics, Phetchabun Hospital between May,1999 and December, 2002. There were 1,924 DHF patients (aged 0-14 years). There were 40 (2.1%) infants (age 0-l years) and 27 (1.4%) young children (age 1-2 years). Sixty-seven cases (3.5%) of the older children (> 2-14 years) were selected to be compared. The clinical and epidemiological data for each of the three groups were not statistically different from each other, except for age, splenomegaly, shock state and mode of dengue infection. Older children were more likely to have a second dengue infection and a shock state than younger patients. Laboratory investigation results and fluid management for each of the three groups were not significantly different from each other except for the total WBC (min), neutrophils (max), lymphocytes (max) and platelets (min). The platelets (min) in the infants were significantly lower than in the younger children and the older children. Associated symptoms, diseases, complications, and hematologic manifestations in each of the three groups were not significantly different from each other except for the presence of coryza, seizures, nausea/vomiting, rash, and petichiae. Coryza, seizures, nausea/vomiting, rash, and petichiae in the infants and younger children were significantly different from the older children.

Fatal dengue encephalitis.

Central nervous system involvement is not an uncommon manifestation of dengue virus infection, but encephalitis is a rare entity. We report the case of a 5-year-old girl with fever and convulsions. She developed coma and shock during the high fever stage without abnormal bleeding.Treatment was supportive and symptomatic. The shock was poorly controlled. High fever persisted for 7.5 days then she expired.Cerebrospinal fluid (CSF) and blood dengue-IgM antibody showed dengue infection.

Parturient and perinatal dengue hemorrhagic fever.

A Thai woman in the shock stage of dengue hemorrhagic fever delivered a healthy infant by normal delivery. She had high, prolonged fever for five days, hepatomegaly, thrombocytopenia and a right pleural effusion. The serology performed later established a diagnosis of secondary dengue infection. She had no serious complications except for postpartum anemia. The newborn became febrile at the 48th hour of life. He had fever for 2 days, hepatomegaly, thrombocytopenia and a right pleural effusion. Dengue virus type 1 was detected from his serum by polymerase chain reaction (PCR). Although he developed prolonged, marked thrombocytopenia (12 days), his illness was uncomplicated. He recovered uneventfully and was discharged with his mother. This report was one of dengue vertical transmission with dengue hemorrhagic fever in humans.